The importance and impact of patients' health literacy on low back pain management: a systematic review of literature

Jean Edward, Leah Yacat Carreon, Mark V. Williams, Steven Glassman, Jing Li

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations

Abstract

Background Context: Health literacy (HL) and the overall ability of patients to seek, understand, and apply health information play an important role in the management of chronic pain conditions. Awareness of how patients' HL skills influence their pain experience and how their ability to understand the treatment regimen and to manage chronic pain may allow physicians to adjust clinical treatment accordingly. Despite the prevalence and the substantial economic impact of chronic low back pain (LBP), little is known about the relationship between HL and the treatment and management of this common disease entity. Purpose: The purpose of this systematic review of published research was to examine the importance and the implications of HL in the treatment and management of LBP. Study Design and Methods: A literature search was performed in Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsychInfo using medical subject heading (MeSH) terms related to LBP, HL, and patient education, which yielded only three studies that directly addressed HL among patients suffering from LBP. Results: We identified only a limited number of studies that focused specifically on HL in the LBP population that were included in this review. The majority of studies excluded from this review focused on patient levels of educational attainment and patient education programs without addressing patients' HL levels and their impact on adherence to educational programs, self-care management, and rehabilitation, among other factors. The three studies that are critically reviewed in this review either use a direct measure of HL or make an effort to address HL in their programs. All three studies emphasize the importance of considering the HL of patients in the treatment and management of LBP. Conclusions: Building on these studies and the narrative review of other relevant literature, we identified significant gaps in current research addressing HL in the treatment and management of LBP. We developed recommendations for future research based on an assessment of strengths and limitations of available evidence-based studies.

Original languageEnglish
Pages (from-to)370-376
Number of pages7
JournalSpine Journal
Volume18
Issue number2
DOIs
StatePublished - Feb 2018

Bibliographical note

Funding Information:
Author disclosures: JE: Nothing to disclose. LYC: Consulting: AO Spine (B), Washington University (B), outside the submitted work; Trips and Travel: Association for Collaborative Spine Research (Travel and Accommodations for Study Planning Meetings 6/2014) (A), Center for Spine Surgery and Research of the University of Southern Denmark (Travel and Accommodations for Study Planning Meetings) (C), University of Louisville Institutional Review Board (funds for travel for Annual Required Continuing Education for Institutional Review Board Members) (B), outside the submitted work; Scientific Advisory Board or Other Office: Spine (Editorial Advisory Board) (none), The Spine Journal (Editorial Advisory Board) (none), University of Louisville Institutional Review Board (none), Scoliosis Research Society (Research Committee) (none), outside the submitted work; Research Support (Investigator Salary, Staff and Materials): Orthopedic Research and Educational Fund (A, Paid directly to institution), Norton Healthcare (D, Paid directly to institution), Scoliosis Research Society (A, Paid directly to institution), Pfizer (E, Paid directly to institution), Integra (D, Paid directly to institution), Nuvasive (provided funds directly to database company) (none), outside the submitted work. MVW: Royalties: Elsevier (the textbook Comprehensive Hospital Medicine, 1st Edition 2007) (none), outside the submitted work; Research Support (Investigator Salary, Staff and Materials): PCORI (Principal Investigator, Project ACHIEVE, 40%; paid directly to institution), BlueCross BlueShield IL (Consultant, PACT, 5%; paid directly to institution), outside the submitted work; Grants: NCATS (Center for Clinical and Translational Science [CCTS], 5%; paid directly to institution), AHRQ (Coinvestigator, MARQUIS, 8%; paid directly to institution). SG: Royalties: Medtronic (as reported in the CMS website), outside the submitted work; Consulting: Medtronic (as reported in the CMS website), outside the submitted work. JL: Research Support (Investigator Salary, Staff and Materials): PCORI (Coinvestigator, Project ACHIEVE, 50%; paid directly to institution), Betty Moore Foundation (Site-PI, evaluating ICAN-supported primary care, 3%; paid directly to institution), outside the submitted work; Grant: NCATS (T&E Core Director, CCTS, 10%; paid directly to institution), outside the submitted work.

Publisher Copyright:
© 2017 Elsevier Inc.

Keywords

  • Health literacy
  • Low back pain
  • Outcomes
  • Pain management
  • Patient education
  • Self-management
  • Treatment

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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